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    Claims Manager - Los Angeles, United States - Regal Medical Group

    Regal Medical Group
    Regal Medical Group Los Angeles, United States

    2 weeks ago

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    Description
    Job Description


    Position Summary:
    Claims processing from data entry to review of all claims prior to payment. Customer service. MM Department support.

    Essential Duties and Responsibilities include the following:

    Daily claims data entry/ manual adjudication
    Daily review of claims status report
    Claims customer service
    Support UM department
    Verify eligibility and benefits
    Encounter data entry
    Verify claims received via fax
    Re-direct claims when necessary
    Claim review with verification of benefits
    Work directly with Northridge office for claims review and payment process
    Communicate with health plan regarding claim appeals
    Meet with Medical Director for claims review
    Review final claim payment EOB's , copying and mailing
    Assist Executives with special projects
    Know location of Policy and Procedure and communication books and be familiar with contents
    All other duties as directed by management


    The pay range for this position at commencement of employment is expected to be between $90,000 - $95,000 annually; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.


    The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

    Details of participation in these benefit plans will be provided if an employee receives an offer of employment.


    If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.


    As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment.

    Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.


    Full Time Position Benefits:
    The success of any company depends on its employees.

    For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members.

    As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

    Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.


    Health and Wellness:
    Employer-paid comprehensive medical, pharmacy, and dental for employees
    Vision insurance
    Zero co-payments for employed physician office visits
    Flexible Spending Account (FSA)
    Employer-Paid Life Insurance
    Employee Assistance Program (EAP)
    Behavioral Health Services

    Savings and Retirement:

    401k Retirement Savings Plan
    Income Protection Insurance


    Other Benefits:
    Vacation Time
    Company celebrations
    Employee Assistance Program
    Employee Referral Bonus
    Tuition Reimbursement
    License Renewal CEU Cost Reimbursement Program
    Business-casual working environment
    Sick days
    Paid holidays
    Mileage


    Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

    Requirements


    Education and/or Experience:
    College Degree and or 5 years IPA experience, Medical office experience

    #J-18808-Ljbffr
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